Neuro-Ophthalmology

Neuro-Ophthalmology

1. What Is Neuro-Ophthalmology?
2. What Are the Main Diseases in Neuro-Ophthalmology?
3. What Are Treatment Methods in Neuro-Ophthalmology?

What Is Neuro-Ophthalmology?

Neuro-ophthalmology is a medical specialty that deals with the relationship between the eye and the nervous system. This branch concerns with eye movement disorders, visual loss, optic nerve diseases and other eye-brain-associated problems. The neuro-ophthalmology studies the brain regions and nerve tracts that coordinate the eye movements. The muscles controlling the eye movements cooperate with the neural signals in the brain. Neuro-ophthalmologists evaluate disorders, lesions or damages in the nerve tracts that control the eye movements.

The Neuro-ophthalmology, which also studies optic nerve diseases, diagnoses and treats increased pressure on the optic nerve (optic neuropathy), optic nerve inflammation (optic neuritis), optic nerve tumors and other optic nerve diseases. The Neuro-ophthalmology also deals with the diseases that cause visual loss for many different reasons. These include post-stroke visual loss, migraine-associated visual problems, optic nerve tumors, and diseases such as multiple sclerosis. Understanding and treating the complex relationship between the eye and the nervous system is the specialty of neuro-ophthalmologists.

A neuro-ophthalmologist is a medical doctor who specializes in ophthalmology and neurology. In this way, they can evaluate and treat the diseases related to both the eye and nervous system.

What Are the Main Diseases in Neuro-Ophthalmology?

• Optic Neuropathy: This is the visual loss caused by damage or inflammation in the optic nerve. The optic neuropathy can develop for a variety of reasons, including multiple sclerosis, glaucoma, temporal arteritis, other autoimmune diseases, tumors or trauma.
• Optic Neuritis: This is the inflammation of the optic nerve and often leads to visual loss. Autoimmune diseases such as multiple sclerosis, infections or some medications can cause optic neuritis.
• Eye Movement Disorders: Patients suffering problems in coordination or control of the eye movements are evaluated by neuro-ophthalmologists. Strabismus, insufficient movement or abnormalities in the eyes may occur due to disorders in the neural control of the eye muscles or movement centers in the brain.
• Post-Stroke Visual Loss: Stroke is the condition that develops when blood flow to the brain is suddenly interrupted. The optic nerve or visual centers in the brain may be affected and visual loss may develop after the stroke.
• Optic Nerve Tumors: Tumors located on the optic nerve are within the interest field of the neuro-ophthalmology. These tumors can compress or damage the optic nerve, resulting in visual problems.
• Migraine-Associated Visual Problems: Some patients with migraine attacks may experience temporary visual problems. This condition develops when the visual centers in the brain or the optic nerve are temporarily affected by migraine.
• Optic Neuritis: This is the visual loss that occurs due to inflammation of the optic nerve. It can manifest itself with symptoms such as blurry vision, faded or lost vision of color.
• Ocular Myasthenia Gravis: This is a form of the Myasthenia Gravis, a neuromuscular conduction disorder, that affects the eye muscles. Symptoms such as eyestrain, double vision, ptosis or weakness in eye movements may develop.
• Optic Disc Edema: This is a condition characterized by optic nerve head swelling and edema. The optic disc edema can be associated with increased intracranial pressure, cranial tumors, hypertension, cerebral edema or papillitis.
• Visual Field Loss: Patients experiencing visual loss in a particular area of the eye (central or peripheral) are evaluated by the neuro-ophthalmologists. Visual field loss can result from damage or diseases in the optic nerve or the optic tracts in the brain.
• Optic Nerve Compression: Tumors, cysts or other structures compressing the optic nerve can affect the optic nerve's function and cause visual loss.
• Optic Nerve Malformations: Congenital optic nerve abnormalities or malformations can cause visual problems ad are evaluated by the neuro-ophthalmologists.
• Neurological Visual Loss: It is the visual loss that develops due to diseases of brain and nerve system. These can include stroke, multiple sclerosis, tumors, trauma, neurological infections and other neurological deficits.
• Optic Nerve Pressure: The increased pressure on the optic nerve is known as glaucoma. This condition can cause damage in the optic nerve or permanent visual loss.
• Movements of Visual Stimulations: Movements or insufficient control of the visual stimulations are within interest field of the neuro-ophthalmology. For instance, continuous or abnormal movements (nystagmus) can be observed in the eyes.
• Pituitary Adenomas: The tumors in the pituitary gland can cause visual loss by compressing the optic nerve. In this case, the neuro-ophthalmologists evaluate the patient and decide on the proper treatment options.
• Optic Nerve Atrophy:Visual loss can develop due to degeneration or damage in the optic nerve. The optic nerve atrophy can arise depending on various reasons. It is diagnosed and treated by the neuro-ophthalmologists.

What Are Treatment Methods in Neuro-Ophthalmology?

Neuro-ophthalmologic treatment methods may vary depending on the type, cause and severity of the disease. Some treatment methods practiced in the Neuro-Ophthalmology are as follows:

• Medication Treatment: Some medications can be used for the patients, which effect the optic nerve and regulate the neural conduction. For example, corticosteroid medications are prescribed for inflammatory conditions such as optic neuritis. Also, acetylcholinesterase inhibitors or immunosuppressive medications can be administered for eye movement disorders to improve neuromuscular conduction.
• Eye Prisms or Eyeglasses: Special eyeglasses or eye prisms can be used for some eye movement disorders. Improving the consistency between the visual field and the eyes, these optic corrections can relive the symptoms.
• Botulinum Toxin Injections: Botulinum toxin injections can be applied for excessively functioning eye muscles (for example, ocular myasthenia gravis). These injections ensure that the muscles are temporarily paralyzed so that the symptoms are relieved.
• Eye Muscle Surgery: Eye muscles may require surgical intervention due to eye movement disorders. These surgical procedures can provide normal eye movements and a better visual field.
• Optic Nerve Reconstruction: In the event of optic nerve damage or cut, optic nerve reconstruction can be performed. These procedures are carried out to repair the optic nerves or replace the nerve with another one.
• Vision Rehabilitation: In some neuro-ophthalmic conditions, rehabilitation programs may be arranged for patients with visual loss or visual field loss. These programs include visual training, optic assistants and various techniques, allowing the patients to make use of their visual capacity in the best manner.